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Neonatal Jaundice
Brandy R. Robinson, MD
Dr. Robinson is in private practice, Methodist Family Health Center, Grand Prairie, TX.
The questions below are based on the article
A 5-Day-Old Neonate with Jaundice.
Choose the single best answer for each question.
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1. All of the following are causes of pathologic jaundice EXCEPT
- Blood group incompatibility
- Metabolic disorders
- Sepsis
- Unconjugated hyperbilirubinemia
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2. Which of the following statements regarding breastfeeding and jaundice is correct?
- Breastfeeding-associated jaundice is due to poor milk quality
- Infants experiencing breastfeeding-associated jaundice should be placed on formula, and breastfeeding efforts should be halted immediately
- Maternal factors such as improper technique, fatigue, and engorged nipples may contribute to poor breastfeeding and decreased caloric intake
- There is no evidence linking breastfeeding with an increased incidence of jaundice
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3. All of the following statements about the physical examination of a jaundiced infant are correct EXCEPT
- A complete neurologic examination is warranted to exclude encephalopathy
- A growth evaluation is needed to assess for feeding difficulties
- Examination of the infants skin should include inspection for color, petechiae, and signs of dehydration
- Examination of the infants skin revealing jaundice from the head to the upper torso excludes any serious signs of systemic jaundice
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4. Which of the following statements regarding prevention of jaundice is correct?
- All newborns should be routinely monitored for jaundice prior to discharge from the hospital
- If the mother seeks prenatal care too late in the pregnancy, jaundice cannot be prevented
- Infants not receiving enough breastmilk can be given dextrose water to prevent dehydration
- Mothers should breastfeed at least 3 times per day
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5. All of the following statements regarding phototherapy are correct EXCEPT
- Conventional and fiberoptic phototherapy are often used in combination
- Fiberoptic phototherapy is superior to conventional phototherapy
- Phototherapy reduces bilirubin levels by 30% to 40% after 24 hours of treatment
- The infant should be monitored during phototherapy for burns, dehydration, and skin rashes
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6. When should phototherapy be discontinued in the jaundiced infant?
- After the infants breastfeeding has improved
- When the infants skin returns to normal tone
- When the total serum bilirubin level reaches
14 mg/dL
- Within 48 hours of treatment
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7. Which of the following statements is correct regarding exchange transfusion in jaundiced infants?
- Exchange transfusion has a mortality rate of 15 to 20 per 1000 infants
- Exchange transfusion is a common procedure for jaundiced infants
- Infants with signs of acute bilirubin encephalopathy or total serum bilirubin greater than the recommended threshold should receive exchange transfusion
- The infants blood is filtered, and recycled blood is returned to the body, eliminating excess bilirubin
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